Preoperative/Postoperative Diagnosis: Abscess of perineum with osteomyelitis of coccyx
Procedure: Exploration of perineum with coccygectomy and debridement of the devitalized tissue
Anesthesia: General
Procedure: Patient was taken to the OR. After adequate general anesthesia, the patietn was turned in a right lateral position. The area was prepped with DuraPrep and draped steriley. The patient had a fistulous tract, which was explored with a blunt clamp. The incision was carried down through subcutaneous tissues. There is a necrotic grey tissue with purulence noted. Culures were taken. This seems to encase the coccyx. The coccyx was removed with a Kocher clamp as well as a rongeur up to the level of the sacrum. The nectroic tissue was well excised. The depth of the wound was approximately 8 cm wiht a wound 10 cm long and 4 cm wide. The bone was exposed and excised as was deep tissues of the pelvis. The wound was inspected for hemostasis. Irrigation was utilized. Cautery was used to help with hemostasis. The wound was then treated with a wound vac, which was bridged to the left anterior thigh. The patient tolerated the procedure and was taken to the recovery room in stable condition.